The effect of low parental warmth and low monitoring on disordered eating in mid-adolescence: Findings from the Australian Temperament Project
Introduction
Eating disorders have a complex aetiology, involving interactions between biological, social, and environmental factors at critical developmental stages (Culbert et al., 2015, Jacobi et al., 2004). Preclinical patterns of disordered eating attitudes and behaviours generally emerge during the peri-pubertal period and may subsequently develop into full eating disorders by adolescence or early adulthood (Herpertz-Dahlmann, Buhren, & Remschmidt, 2013). There remains uncertainty about the early determinants of disordered eating behaviours, because few longitudinal studies of child and adolescent development have captured eating pathology. Some studies (e.g. Agras et al., 2007, Berge et al., 2010, Zubatsky et al., 2015) have suggested that particular parenting practices may predict subsequent eating problems. The present study uses unique developmental data from a large Australian cohort study, to examine relationships between parents’ descriptions of their warmth and monitoring parenting styles and their adolescent’s self-reports of disordered eating behaviours and symptoms two years later.
Parenting behaviours are commonly conceptualized on two dimensions: (a) the extent to which parents nurture their child (i.e., “responsiveness/warmth”) and (b) the degree to which parents monitor their child (i.e., “aware of their child’s daily activities and whereabouts”) (Baumrind, 1975). The parent-child relationship, in particular, family interaction styles typified by high levels of conflict and enmeshment and low levels of cohesion and warmth, have been associated with clinical eating disorders (Tetley, Moghaddam, Dawson, & Rennoldson, 2014) and disordered eating in community samples (Horesh et al., 2015, Loth et al., 2014). Inconsistent findings have however also been observed, with a few studies revealing only a weak or no relationship between parenting practices and subsequent eating pathology (Hautala et al., 2011, Krug et al., 2015). It should also be noted, that most studies are cross-sectional or retrospective in design (limiting causal inference) and based on convenience samples with limited generalizability. Only a few studies, using a prospective design have implicated parenting styles, including low warmth and low monitoring, in eating pathology (Berge et al., 2010, Zubatsky et al., 2015). Yet other studies have suggested the effects of parental and family influences are as strong as other factors such as depression, peer pressure and body dissatisfaction (Lyke and Matsen, 2013, Paxton et al., 2006).
Importantly, little is known about the interaction between parenting practices in relation to eating pathology. This is surprising given that the practices of warmth and monitoring exist in all combinations across family structures within populations (Baumrind, 1975). Neglectful-disengaged parenting has been associated with a mixture of internalizing and externalizing negative health outcomes in adolescence, including depression (Katz et al., 2014), emotional distress (Operario, Tschann, Flores, & Bridges, 2006), conduct disorder (Racz & McMahon, 2011) and eating pathology (Berge et al., 2014). However, little is known about other forms of interactions between parenting styles. Yet, identification of such interactions has the potential to define important sub-populations of those most at risk and to more accurately target preventive interventions (Berge et al., 2014).
The purpose of this study was to examine relationships between parent-reported parental warmth and monitoring, and their interaction, in early adolescence (age 13–14) and subsequent risk of disordered eating behaviours in mid-adolescence (age 15–16). Data were drawn from a large population based longitudinal study that has followed the social and emotional development of over 2000 participants and their families from birth in 1983 across 30 years (15 waves) of data collection: The Australian Temperament Project (ATP).
Section snippets
Participants
Data are based on 1300 parents and offspring who participated in the ATP between early and mid-adolescence. The ATP has followed the social and emotional development of a large population-based cohort from infancy (4–8 months) to adulthood (27–28-years) across three decades (15 waves) since 1983. The initial sample comprised 2443 infants and their parents and were from urban and rural areas of the state of Victoria, Australia. Details on sample characteristics and sampling are provided in
Descriptive statistics for parental practices and disordered eating
The means and standard deviations (SD) and range of scores for the key variables are presented separately for males and females in Table 2. The mean value of parental warmth and monitoring was higher in males than females. Conversely, more females than males reported body dissatisfaction, drive for thinness and bulimia.
Table 3 presents frequencies for exposure (warmth and monitoring) and outcome variables (eating pathology) used in regression models. Low parental monitoring was more common in
Discussion
This study examined the main and additive interaction effects of low parental warmth and low monitoring on disordered eating in a large sample of Australian adolescent girls and boys. There was little evidence that low parental warmth and monitoring in isolation increased the risk of disordered eating in either girls or boys. For girls, the only significant main effect was found for low parental warmth in relation to bulimic behaviour. There were no main effects for boys. However, there was
Conclusions
Using unique data from a large population based cohort study (the ATP), this study aimed to provide a deeper understanding of how parenting practices may be related to risk for disordered eating attitudes and behaviours in female and male adolescents. Our results suggest that for girls, risk for bulimic behaviour is increased in those living with a low warmth parent and that risk for body dissatisfaction and drive for thinness is increased in those living with a low warmth and low monitoring
Authors contributions
IK, RK, AS and CO drafted the manuscript and conceptualized the aims and hypotheses. GY conducted the analyses and helped revise the manuscript. CO, and PL set up data collection and obtained funding for the project. EW contributed to measurement selection related to body dissatisfaction and disordered eating. EW, DLG and EH provided feedback on different versions of the manuscripts. All authors read and approved the final manuscript.
Acknowledgements
CO is supported by an ARC Principal Research Fellowship [DP1311459]. The ATP study is located at The Royal Children’s Hospital Melbourne and is a collaboration between Deakin University, The University of Melbourne, The Australian Institute of Family Studies, The University of New South Wales, The University of Otago (NZ), and the Royal Children’s Hospital; further information available at www.aifs.gov.au/atp. The views expressed in this paper are those of the authors and may not reflect those
References (60)
- et al.
Childhood risk factors for thin body preoccupation and social pressure to be thin
Journal of the American Academy of Child and Adolescent Psychiatry
(2007) - et al.
Parenting style as a predictor of adolescent weight and weight-related behaviors
Journal of Adolescent Health
(2010) - et al.
The efficacy of the triple P-positive parenting program in improving parenting and child behavior: a comparison with two other treatment conditions
Behaviour Research Therapy
(2008) - et al.
Testing the original and the extended dual-pathway model of lack of control over eating in adolescent girls. A two-year longitudinal study
Appetite
(2014) - et al.
The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies
International Journal of Surgery
(2014) - et al.
A preliminary investigation of the relationship between induced rumination and state body image dissatisfaction and anxiety
Body Image
(2010) - et al.
Family-based treatment of child and adolescent eating disorders
Child and Adolescent Psychiatric Clinic of North America
(2015) - et al.
The role of gender, affectivity and parenting in the course of disordered eating: a 4-year prospective case-control study among adolescents
International Journal of Nursing Studies
(2011) - et al.
Adolescents’ level of eating psychopathology is related to perceptions of their parents’ current feeding practices
Journal of Adolescent Health
(2014) - et al.
Father-daughter relationship and the severity of eating disorders
European Psychiatry
(2015)
Parent emotional distress and feeding styles in low-income families. The role of parent depression and parenting stress
Appetite
A new social-family model for eating disorders: a European multicentre project using a case-control design
Appetite
Family functioning and risk factors for disordered eating
Eating Behaviours
Unhealthy behaviors and psychosocial difficulties among overweight adolescents: the potential impact of familial factors
Journal of Adolescent Health
Parental influences on children’s eating behaviour and characteristics of successful parent-focussed interventions
Appetite
Brief report: associations of parental warmth, peer support, and gender with adolescent emotional distress
Journal of Adolescence
Parent binge eating and restrictive feeding practices: indirect effects of parent’s responses to child’s negative emotion
Eating Behaviours
Early family experiences of women with bulimia and depression
Archives of Psychiatric Nursing
Parental bonding and eating disorders: a systematic review
Eating Behaviours
The understanding of risk factors for eating disorders in male adolescents
International Journal of Adolescent Medecine and Health
The contributions of the family to the development of competence in children
Schizophrenia Bulletin
Marital quality and psychological adjustment among mothers of children with ASD: cross-sectional and longitudinal relationships
Journal of Autism and Developmental Disorders
The unique and additive associations of family functioning and parenting practices with disordered eating behaviors in diverse adolescents
Journal of Behavioral Medicine
Longitudinal examination of maternal psychological control and adolescents’ self-competence as predictors of bulimic symptoms among boys and girls
International Journal of Eating Disorders
Flavors in gene-environment interactions
Epidemiology
Commentary: facing the challenge of gene-environment interaction: the two-by-four table and beyond
American Journal of Epidemiology
Outcome of anorexia nervosa: eating attitudes, personality, and parental bonding
International Journal of Eating Disorders
Anorexia nervosa and parental bonding: the contribution of parent-grandparent relationships to eating disorder psychopathology
Journal of Clinical Psychology
Research review: what we have learned about the causes of eating disorders - a synthesis of sociocultural, psychological, and biological research
Journal of Child Psychology and Psychiatry and Allied Disciplines
Prospective associations of concerns about physique and the development of obesity, binge drinking, and drug use among adolescent boys and young adult men
JAMA Pediatrics
Cited by (15)
Family cohesion and a father's warmth are related to the positive lifestyles of female university students
2018, KontaktCitation Excerpt :BMI is also associated with low parental warmth and high parental hostility [26]. Particularly in adolescent women, low parental warmth is associated with bulimic behaviours [27]. Meanwhile, the sense of belonging to an indigenous group (such as the Zapotec) has been associated with better eating habits [28].
Risk factors for eating disorders: findings from a rapid review
2023, Journal of Eating DisordersRisk Factors of Disordered Eating in Adolescent Girls from a Community Sample: A Multidimensional Approach
2023, Consortium PsychiatricumEating and Body Image Disturbances in Adolescence and Substance Use Throughout Young Adulthood: Findings from the Australian Temperament Project
2023, International Journal of Mental Health and AddictionIndirect Effects of Parent–Child Relationship Quality and Media on Emerging Adult Body Esteem
2022, Journal of Child and Family StudiesParenting Styles and Disordered Eating Among Youths: A Rapid Scoping Review
2022, Frontiers in Psychology